A traumatic event, the death of a close person, the transition from work to retirement, an illness: they are enough to change the life of the elderly, to make them enter a dimension of “fragility”, from which they may not even return. They enter a vicious circle: they eat little, they don’t go out, they isolate themselves. To study this condition, which in Italy is expanding from year to year, the Mondino Institute of Pavia has engaged a team of 17 researchers for 15 years. Research Frailbiotrack, on the biological roots of “frailty” in the elderly, was promoted by the Mondino Foundation, in collaboration with the Golgi Cenci Foundation of Abbiategrasso and the Mario Negri Institute of Milan, with the contribution of the Cariplo Foundation.
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By “frailty” we mean a condition typical of the geriatric age, when the person responds less and less effectively to environmental stimuli. The frail elderly person is not yet ill, but is more vulnerable than other peers to diseases that can affect various organs. Studying the condition of frailty can therefore help prevent or slow down the onset of pathologies, improving the quality of life and moving away from the moment of loss of autonomy and recourse to hospitalization.
The Frailbiotrack team work was conducted on 762 elderly people to study the mechanisms that cause frailty in the elderly. The researchers had a homogeneous population available for a long period of time: the people recruited, born between 1935 and 1939 and residing in Abbiategrasso, in the province of Milan, were included in 2009 in the InveCe study. in Abbiategrasso and re-evaluated in 2012, 2014 and 2018. This allowed us to draw a picture of the phenomenon.
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“The data obtained from the population study were able to highlight how there are risk factors linked to lifestyles that influence the incidence of frailty – he explains Antonio Guaita, Head of the Operational Unit of the Golgi Cenci Foundation -. Interesting and new is precisely the fact that these are modifiable behaviors in elderly people: to reduce the incidence of frailty, therefore, the possibility of effectively intervening with preventive actions is opened not only in young and adult subjects but also for those who are in old age “.
Over 8 years, frail people increased from 7.5% to 26.4%. Therefore, those who have seen their health conditions deteriorate more than tripled, often with loss of autonomy and the need for more assistance. On the other hand, the “non-fragile” fell from 36.2% to 16.1%, slipping into a condition of “pre-fragility” or fragility.
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Mondino’s study made it possible to make a qualitative leap, identifying some biological markers of inflammatory states in the body, a typical process in aging but which significantly increases in more fragile subjects than in the elderly who maintain good health. In particular, the role of cell microvesicles in spreading inflammation could open new perspectives for studies on the mechanisms of aging.
“The results obtained during this project have further underlined the complexity of frailty in the elderly – he explains Cristina Cereda, project coordinator for the Mondino Foundation – the involvement of three main components emerged: inflammation, diet and cognitive decline. A further study of these fragility indicators could in the future open towards new and more profitable strategies for the prevention of fragility “.
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Prevention that, Cereda confirms, can be obtained “by changing one’s lifestyle and reviewing one’s diet”. In practice, lots of fruit and vegetables and a glass of wine a day can make a difference, if combined with daily physical activity and help to fight inflammation. “Which is often linked to oxidative stress of the cells – continues Cereda -. So you can take antioxidants through the diet or excipients to be prescribed to help the diet itself to lower the redox state in the cells, which is the basis of aging. “.
“The frailty linked to aging is a topic of great relevance and topicality, both from the socio-health point of view and from the scientific research point of view. Even more important for a neurological Irccs like the Mondino Foundation, for the relationship that links aging to diseases of great social impact such as dementia or Parkinson’s – he explains Fabio Blandini, scientific director of Mondino -. It is therefore an area in which our researchers are deeply committed, through national and international collaborations that have recently yielded funding, from several bodies, for the study of the multiple and complex biological, molecular, pharmacological and social aspects that could be at the basis of the frailty linked to aging “.
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“Through the preclinical study we have characterized the functional and cerebral changes in a mouse model of fragility along the different stages of aging – adds Claudia Balducci, head of the operative unit of the Mario Negri Institute -. This model proved to be very useful within the project, as it faithfully reproduces the condition of the frail subject, including weight loss, weakness, fatigue and cognitive impairment. We have shown that, in accordance with the clinical evidence, functional deficits are associated with alterations of the inflammatory brain cells which, probably, are also responsible for the progressive loss of nerve cells found in these animals. Taken together, these alterations represent essential markers to evaluate, in the future, the effectiveness of interventions aimed at preventing frailty “.
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